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Sexual Irresponsibility Among Young Adults 1 Tyler Burlingame, Nicole Rothberg, Stephanie Nelson Professor DiRosa Consumer Health Decisions Responsible Sexual Behavior Sexual Irresponsibility Among Young Adults 2 Introduction Sexual health has become a huge issue in the United States especially among young adults. This issue lies in whether or not they are demonstrating sexually responsible behaviors or are they doing the opposite? Are they taking proper precautions to protect their sexual health, such as using barrier methods and birth control? And are these young adults participating in unprotected sexual encounters? Each year, STDs (including HIV) among young men and women result in significant public and social costs (Dariotis, Sifakis, Pleck, Astone, & Sonenstein, 2011). This is probably no shock to anyone, as evidence by how much 'sex' is promoted on TV. Attitudes have changed towards sexual encounters as well as the amount of partners, one engages in sexual activity with. Half of the approximately 18.9 million new STD cases each year are among sexually active 15-24-year-olds, although that population constitutes only one-fourth of the sexually active population overall (Dariotis, 2011). This is considered an alarming rate of STD cases each year. And of the population that is not included in the new cases accumulated, how many other young adults have been exposed to STDS? How many are at risk that could be prevented from contracting a disease that could potentially affect them for the rest of their lives? Also how many women will be at risk for pregnancy do to improper sexual conduct? These are questions that plague the United States currently. There are many facets to why conducting sexual responsibility can be so difficult. These include misinformation, changing sexual attitudes, religion, and the misguided thoughts that 'it won't happen to me". Sexual Irresponsibility Among Young Adults 3 Research Question To what extent are RU college students engaging in irresponsible sexual behaviors? Significance Statement Responsible sexual behavior consists of adult roles and responsibilities, teen pregnancy, and sexually transmitted diseases. This study is significant because it expands on previous research, addressing the reality of irresponsible sexual behavior when life’s daily factors are involved (alcohol, temptations, peer pressure, etc.). Literature Review Sexual Behaviors of College Students Each college student, whether they are a freshman or a senior has had some sort of sex education at some point in their lives whether it was from a teacher, counselor, or a parent. This type of education is vital to the well-being of a college student because it is a step towards protecting oneself from sexually transmitted infections and unwanted pregnancies. If students are not receiving this information at an early age, they are at risk of not knowing the dangers of unprotected sexual intercourse, whether it be oral or genital to genital. Foster et al. (2012), conducted a study that surveyed, “1,497 women and men at 75 clinics and physician offices across California after their reproductive health care visits in late 2007 and early 2008. When asked if they would have sex without contraception, 30% said definitively that yes, they would have unprotected sex, and 20% indicated they would ‘‘sometimes’’ or ‘‘maybe’’ engage in unprotected sex” (61). This study revealed that about 450 people of 1,497 people stated that they would definitely engage in unprotected sex and about 300 Sexual Irresponsibility Among Young Adults 4 people out of 1,497 people stated that they would do it “sometimes” or “maybe” (Foster, et al., 2012). In total that is 750 out of 1,497 (half) college students that state that they would potentially engage in unprotected sex. For the small percentage of college students that will turn down unprotected sex, they always look for an alternative because there always is one; oral sex. A lot of college students have the perception that oral sex is safer genital to genital contact but it is really just as unsafe if one does not where either a condom or a dental dam (mouth condom). Many diseases can still be passed this way and college student will choose to look past this just to feel some sort of pleasure. A study conducted by Chambers (2007), revealed that, “out of 1,180 non-virgin responders, a total of 1,137 (96.4%) indicated that they had given or received oral sex from someone in their lifetime” (31). The article did not state whether or not these students were using protection but when comparing them to Foster et al. (2012) research that stated that thirty percent of 1,497 college students would have sex without a condom it seems likely that students are not protecting themselves when it comes to oral sex (61). Birth Control Methods of College Students Contraceptives and college students should go hand and hand without question, but how do college students see contraceptives as a whole? Nearly 80% of women engaging in contraception currently used a non-coital dependent method. After adjustment for age, race, and location where contraception was obtained, current non-coital dependent users were significantly more likely to be satisfied with their contraceptive method compared to women using coital dependent methods (Ersek, J., Huber, L., Thompson, M., & Findlow, J., 2010). Coital Sexual Irresponsibility Among Young Adults 5 dependent refers to condoms and diaphragms vs. Non coital dependent which means the pill or other types of contraception that affect your hormonal balances to limit the chances of pregnancy. Women who previously used non-coital dependent methods of contraception were 91% less likely to have discontinued their last contraceptive method compared to women who used coital dependent methods, and this association was statistically significant (Ersek, et al, 2010). Which overall means that condoms are not a preferred method of birth control. And probably for reasons such as, "It doesn't feel as good" or "I'm allergic to latex". Even though there are other options beyond latex there’s also a lamb skin condom as well. Whereas hormonal birth control seems to be the contraception of choice, considering there was less women changing it to something else. Other reasons for discontinuing their last contraceptive method included wanting to or becoming pregnant, stopped having sexual intercourse, cost, and being in a monogamous relationship (Ersek, et al, 2010). Prevention and Testing College life to students is seen as school work and a party zone. There are tons ways that prevention techniques are promoted, such as television, computers ad, and the lessons they are taught in school. But how different types of prevention methods are offered? There are male and females condoms, types of birth control (pill, patch, and injection), NuvaRing, spermicides, plan B, diaphragms, withdrawal and abstinence (which is the safest and most effective method). Students at this age think they know “everything” there is to know about sex, sexual diseases, and the methods of protections offered. But, most are misinformed. College students are an extremely vulnerable population for getting STDS. In a study by Eisenberg et al (2012), the Sexual Irresponsibility Among Young Adults 6 authors report on how a diverse group of college student views could have an impact on health resources that could have a critical step towards the effectiveness of student’s sexual needs (Eisenberg, Garcia, Frerich, Lechner, & Lust, 2012). In the study conducted, there were seventyeight college students with an average 20 years of age that attended five Minnesota colleges. Both two- and four-year institutions were included into the study. Participants participated in “go-along:” interviews that lead researchers around their campus, physically and virtually, to explore the sexual health resources in the setting. 88.5 % of condom distribution programs were located on campus, 80.8% of on campus health clinics, 75.6% off- campus clinics, and 71.8 % sexual health information offered to students. To conclude the study, it showed that students that were informed about the different prevention methods saw it as “accessible, comfortable, and useful” (Eisenberg et al., p., 2012). Getting tested for STDS/HIV is also extremely important when it comes down to responsible sexual behavior. The more an individual gets tested the better treatment one can require. A study was conducted between 957 unmarried recent college students in the United States. Students were asked about HIV Testing, the past six-month sexual activities they’ve encountered, treatment for any previous sexually transmitted diseases, past-year health service utilization, and DSM-IV criteria for alcohol and other drug (AOD) dependence during the 20082009 academic year. Two in five out the sample group were tested for HIV in their lifetime. All of the following aspects related to the results of the study: HIV testing was positively related to AOD dependence, unprotected sex, number of sex partners, having a physical exam by a medical professional, number of visits to a health provider for physical health problems, and lifetime STI treatment. Since women were more likely to be tested due to yearly visitations to a medical Sexual Irresponsibility Among Young Adults 7 profession, males were less likely to be tested. The concluding results showed that there was a high HIV testing rate in the college population (Caldeira, Singer, O'Grady, Vincent & Arria). Alcohol and its Influence on Unprotected Sex As college students become more and more accustomed to life on campus and begin to meet new people, they begin to socialize with these people on a less intellectual level. One way, and more than likely one of the only ways outside of class, people socialize is by engaging in alcohol consumption at parties and if they are of age at bars. Alcohol consumption impairs one’s ability to think straight and make conscious decisions on determining right from wrong. One thing that alcohol always has a knack for influencing is sexual behavior. It is one of the main causes of regretted sex and more than likely has caused more unwanted teen pregnancies and sexually transmitted disease transmission than any drug out there. Orchowski, Mastroleo, and Borsari (2012), stated that, “results indicated that alcoholrelated regretted sex occurred at similar rates in mandated and volunteer students, with approximately 25% of the students reporting at least 1 occurrence in the past month. Women were more likely to report alcohol-related regretted sex compared with men” (783, 2012). After reviewing these findings, a quarter of the people surveyed reported to have at least one instance in the last month that they regretted. If a quarter of people regretted a sexual encounter in one month, one can really only imagine what the percentage would be over the past year. In another article that was conducted by Megan Patrick and Jennifer Maggs of Penn State University, state that, “Hingson, Heeren, Winter, and Wechsler (2005) estimated that 8% of U.S. college students ages 18 to 24 years (474,000 people) have unprotected sexual intercourse Sexual Irresponsibility Among Young Adults 8 resulting from alcohol use annually” (Patrick & Maggs, 2009). After reviewing this statement of the article, one can’t help but to think that this is not true; especially one that is still in college. It is hard for one to believe that only 8% of close to half a million college students have unprotected sex annually, but with the sample population being as large as it is, it makes it hard for a person to not believe the statistics shown. Cultural or Social Norms of Sexual Behavior In today’s world of sexual behavior, we as a whole have come to the conclusion that the word “responsible” would not come to mind. As generations go on, teen pregnancy is becoming more popular, sexual partners are immensely increasing, and individuals have different perspectives of what sex emotionally means to oneself now. In today society, many college students seen sex as “hooking-up” which can be seen as a casually encounter or “one-night stand”. In the article, Sex Ed: Combating the Campus Culture, the author refers to the term “hook-up” as casual sex with no intentions of commitment (Jackson, C. K. 2011). Although this article is focusing more on the African – American race; ethnicity has no influences on “hooking up”. All cultures are involved in these seamless acts of sex. Jackson states that college students are facing a dating scene more complicated than that of previous generations (Jackson, C. K. 2011). We now have technology that is a huge factor in relationships. Between Facebook, Twitter, and online dating sites it’s extremely hard not to be sucked into temptations and talk to individuals that are primarily not your significant other. Some students in college see relationships as this age are a waste of time so they rather not get involved, where then the “hook-up” thought process comes in hand. Why be committed when Sexual Irresponsibility Among Young Adults 9 you can simply get what you want in one night? By engaging in these irresponsible actions, this leads to unwanted pregnancies and STIs (Jackson, C. K. 2011). Peer Pressure is also a huge influential factor that consume college students lives every day. Typically, student’s wants to lose their virginity before college because you may be considered a “prude” otherwise. In that case, there was a study conducted on the transition from virgin to non-virgin status. There was a total of 884 middle school students completed a pretest and a 1-year follow-up questionnaire (Laflin, M. T., Wang, J., & Barry, M., 2008). . At Time (1), 52 students reported already having initiated sexual behavior; the remaining 832 students were included in the analyses. The sample was 58.5% female and 92.8% white, with a mean age of 12.84 years. At Time (2), 105 students (12.6%) had changed their coital status from virgin to non-virgin (Laflin, et al, 2008). We thought this article was interesting because these kids are so young and still falling into peer pressure. As the high school years follow this middle school age teens, the transition from rom virgin to non-virgin is only going to increase (Laflin, et al, 2008). . Drinking, drugs, and sex will be temptations that may not have been a part of an individual’s life previously. Young peoples' perceptions of their peers' attitudes about sex had the strongest impact on sexual activity and whether or not they will be sexual activity or not. Religious Influence on Sexual Behavior It seems that there has always been a debate between Sex and Religion and how they affect each other. In the Christian faith they always capitalized on waiting until marriage and give yourself completely to one person only. Christian ethics has always taken a complex view of the goods and purposes of human sexuality and its role in human relationships. Sexual desire Sexual Irresponsibility Among Young Adults 10 and behavior have to be seen always within the overarching moral imperatives of love of God and love and neighbor. Such love entails self-giving and other-regard, and in longer term relationships also some measure of commitment, fidelity, reciprocity or mutuality, truthfulness and generativity (Wondra, 2012). The principle of all this is that sex shouldn't make the relationship; it should only complement and already existing healthy relationship between two individuals. The criterion here is the extent to which sexual desire and sexual expression (physical or otherwise) tend towards the greatest well-being of all involved-well-being of heart, mind and spirit as well as body. This criterion recognizes that the well-being of each depends on the well-being of all. It also rules out violence, coercion, and emotional, physical and spiritual abuse, exploitation, and indifference (Wondra, 2012). This means that any type of foul play regarding sex is not considered to be sex but a violation of trust among other principles. Faith and religion can play a huge role in someone's life including their sexual life. Results from a study on indicated differences in sexual attitudes, religiosity, and spirituality by gender. Moreover, sexual attitudes, religiosity, and spirituality were associated with sexual behaviors among college students (Luquis, Brelsford, & Rojas-Guyler, 2012). Religion can play a role in whether or not a person partakes in sexual activities but also how many people one engages in sexual activities with. Moore and Davidson (2006) found that conservative sexual attitudes were present among a group of young women who embraced the notion of love before sexual intercourse, who disapproved of cohabitation, and who held a desire to get married to someone with whom only they have had sexual intercourse (Luquis et al, 2012). In this study, high levels of religiosity were associated with lower numbers of lifetime sexual partners and less frequency of vaginal intercourse, while higher levels of spirituality were associated with higher Sexual Irresponsibility Among Young Adults 11 numbers of lifetime sexual partners, more frequent vaginal intercourse, and higher instances of sex without a condom among females (Luquis et al, 2012). Methodology The population being used in this study is Rowan students. These students will be handed a survey that asks them to be honest about their sexual health, as it is completely anonymous. We will give them the space they need to fill out this survey to not create discomfort or dishonesty. This survey will be handed out on school campus mostly. The survey is mostly in yes no form but also check this box if this applies to you. There also includes one question that asks you to list a reason to answer if need be. We will start handing out the survey once our final drafted survey has been approved. Pilot Test The pilot test that we conducted during class consisted of seven surveys distributed to the other groups in class. This pilot test consisted of four males and three females. Of the seven people surveyed, five were commuters and two were residents. Five people surveyed were between the ages of 17-20, two were between the ages 21-25, and six of the seven people were sexually active. Not one person of the seven that completed the survey have engaged in unprotected sex and three out of the seven were in a relationship. Of the three women that were surveyed, two of them were on some kind of birth control. The popular choice of protection chosen by our class was male condoms (5), withdrawal (2), birth control pills (2), and Plan B (1). Five of the seven people have engaged in sexual activity while under the influence of alcohol and only one person stated that their religious beliefs affected the way they thought about sex. Sexual Irresponsibility Among Young Adults 12 Timeline September 6th: Topics were chosen. September 13th: Our Research Question was due. September 20th: Project Summary due. September 27th: Survey Draft due. October 4th: Chapter 2 Outline due. October 11th: Chapters 1-3 due on Blackboard November 15th-26th: Began Distributing Surveys to Students amongst our classes. November 28th: Compiled Information and put into graph December 3rd: Finalized our Research, Created PowerPoint, Discussed our plans for our presentation Results Table 1: Participant Characteristics Percentage (%) Characteristics Gender Male 48% Female 52% Residency Status Commuter 60% Resident 40% Age 17-20 43% 21-25 57% Sexual Irresponsibility Among Young Adults 13 Table 2: Sexual Behaviors of Participants Characteristics Sexually Active Yes No In a Relationship Yes No Engaged in Unprotected Sex Yes No Sex Influenced by Alcohol Yes No Number of Sexual Partners 0 1-5 13% 43% Percentage (%) 83% 17% 45% 55% 60% 40% Always 13% Sometimes 32% N/A 55% 67% 33% 6-11 31% 12-17 10% 18+ 3% Table 3: Types of Birth Control Taken by Participants (Population) Type of Birth Control Number of People (n) Male Condoms n= 60 Female Condoms n= 0 NuvaRing n= 7 Birth Control Injections n= 7 Spermicides n= 10 Abstinence n= 16 Withdrawal n= 13 Diaphragm n= 0 Birth Control Pills n= 42 Plan B n= 2 Sexual Irresponsibility Among Young Adults 14 Results Discussed After reviewing our final results, we found that irresponsible sexual behavior was not as high as we had expected. Our participants consisted of 48 males and 52 females. Of a total of 100 people surveyed, 60 of them were commuters and 57 of them were between the age of 21 and 25. In distributing our surveys, race and ethnicity did not play a factor. Our surveys were distributed evenly amongst our group of three people with one person passing our 34 surveys instead of 33. The sexual behaviors of our participants played the biggest factor in our surveys. In our results, we found that 83 people were sexually active and 45 of the 100 people we surveyed were in committed relationships. Of the 100 survey participants, 60 people claimed to have some sort of unprotected sex; 13 people stated that they engage in unprotected sex always, 32 people said they engage in unprotected sex sometimes, and 55 of the people simply left that part of the survey blank for reasons that were beyond us. Our survey asked a question in regards to people having sex while under the influence of alcohol and of the sexually active people that answered this question 67 of them stated that they have. Surprisingly, our survey participants were on the low end of the amount of sexual partners that they have been involved with; 43 of our participants have had 1-5 partners, 31 participants have had 6-11 partners, 10 participants have had 12-17 partners, and only 3 participants have had 18+ partners. The big surprise to our group was the 13 participants that still hold on to their virginity. This was shocking and we were happy to see that 13% of our 100 students still retain their virginity. When it came to birth control, we were not surprised that male condoms and birth control were the highest used form of contraception. Male condoms received 60 users and and Sexual Irresponsibility Among Young Adults 15 birth control pills had 42 users of the 52 females surveyed. Another surprise to our group was the abstinence was the third leading form of contraception used by our survey participants (16 people). This must mean that besides the 13 virgins that we surveyed, three other individuals, although not virgins began to practice abstinence again after their last sexual experience. Birth control injections and NuvaRing each had seven users, spermicides had 10 users, withdrawal had 13 users, plan B had 2 users, and female condoms and diaphragm each had 0 users. Sexual Irresponsibility Among Young Adults 16 Sexual Behavior among College Students Hello! For our Consumer Health Decisions class at Rowan University, we are conducting a survey which will help us gather information about Responsible Sexual Behavior. All information is anonymous therefore names will not be needed. If you could take a couple minutes out of your time to fill it out, it would be greatly appreciated! Thank you again for your time! Demographic Questions: □ Male □ Commuter □ Female □ Resident □ Age 17-20 □ Age 21-25 Sexual Behavior: 1. Are you sexually active? (Defined as: Sexual contact between individuals involving penetration) □ Yes □ No 2. Are you currently in a committed relationship? (Monogamous) □ Yes □ No 3. Have you ever engaged in unprotected sex? (Sex without birth control methods; condoms, pills, withdrawal) □ Yes ( If yes, how often would you say you do this - always, sometimes, never) □ No ____________________________________________ 4. Female Only: Do you take birth control? (I.e. Pills) □ Yes (If yes, do you do so for non-sexual related issues? (i.e. treatment for condition) □ No ____________________________________________ 5. When you do use birth control methods, what type do you use: (Check all that apply) Male Condoms □ Abstinence Female Condoms □ Withdrawal NuvaRing □ Diaphragm Birth Control Injections (Depo-Provera) □ Birth Control Pills Spermicides □ Plan B 6. Have you ever been tested for HIV/AIDS, HPV, Gonorrhea, Chlamydia, and Herpes? □ □ Yes No (If not, why?) ___________________________________________ 7. How many sexual partners have you had? (Intercourse) □ 1-5 □ 6-11 □ 12-17 □ 18 + 8. Have you ever engaged in sex while under the influence of alcohol? □ □ No Yes 9. Do you believe that your Religious beliefs have any influence over your sexual behaviors? □ Yes □ No Sexual Irresponsibility Among Young Adults 17 Works Cited Caldeira, K. M., Singer, B. J., O'Grady, K. E., Vincent, K. B., & Arria, A. M. (2012). HIV Testing in Recent College Students: Prevalence and Correlates. AIDS Education & Prevention, 24(4), 363-376. doi:10.1521/aeap.2012.24.4.363 Chambers, W. (2007). Oral sex: varied behaviors and perceptions in a college population. Journal of Sex Research, 44(1), 28-42 Dariotis, J. K., Sifakis, F., Pleck, J. H., Astone, N. M., & Sonenstein, F. L. (2011). Racial and ethnic disparities in sexual risk behaviors and STD’s during young men's transition to adulthood. Perspectives On Sexual & Reproductive Health, 43(1), 51-59. Eisenberg, M. E., Garcia, C. M., Frerich, E. A., Lechner, K. E., & Lust, K. A. (2012). Through the eyes of the student: What college students look for, find, and think about sexual health resources on campus. Sexuality Research & Social Policy: A Journal Of The NSRC, 9(4), 306-316. doi:10.1007/s13178-012-0087-0 Ersek, J., Huber, L., Thompson, M., & Findlow, J. (2010). Satisfaction and discontinuation of contraception by contraceptive method among university women. Maternal and Child Health Journal. 15(4). 497 – 506 Foster, D., Higgins, J., Biggs, M., McCain, C., Holtby, S., & Brindis, C. (2012). Willingness to have unprotected sex. Journal of Sex Research, 49(1), 61-68 Hingson, R., Heeren, T., Winter, M., & Wechsler, H. (2005). Magnitude of alcohol-related mortality and morbidity among U.S. college students ages 18–24: changes from 1998 to 2001. Annual Review of Public Health, 26(2), 259–279 Jackson, C. K. (2011). Sex Ed: Combating the Campus Culture. Ebony, 66(11), 95. Laflin, M. T., Wang, J., & Barry, M. (2008). A longitudinal study of adolescent transition from virgin to nonvirgin status. Journal Of Adolescent Health, 42(3), 228-236. Sexual Irresponsibility Among Young Adults 18 Luquis, R., Brelsford, G., & Rojas-Guyler, L. (2012). Religiosity, spirituality, sexual attitudes, and sexual behaviors among college students. J Relig Health. 51(1), 601–614 Orchowski, L. M., Mastroleo, N. R., & Borsari, B. (2012). Correlates of alcohol-related regretted sex among college students. Psychology Of Addictive Behaviors, 26(4), 782-790 Patrick, M. E., & Maggs, J. L. (2009). Does drinking lead to sex? Daily alcohol–sex behaviors and expectancies among college students. Psychology of Addictive Behaviors, 23(3), 472-481 Wondra, E. (2012). The goods of human sexuality: Ethics and moral theology. Journal of Anglican Studies, 10(1), 25-30.